Facilitating patient monitoring

ABSTRACT

A method includes receiving from a health care practitioner input corresponding to creation of a first health care order which includes one or more parameters associated with a health care goal for the patient, one or more parameters associated with one or more rules for communicating notifications regarding the first health care order to the first health care practitioner via the electronic health records application, and instructions for the patient for complying with the first health care order. The method further includes displaying to the patient a patient portal comprising a goals interface which displays information associated with the first health care order for the patient created by the first health care practitioner, and allowing the patient to input readings for the order. The method further includes communicating one or more notifications back to the electronic health records application based on the readings.

CROSS-REFERENCE TO RELATED APPLICATION

The present application is a U.S. nonprovisional patent application of,and claims priority under 35 U.S.C. § 119(e) to, U.S. provisional patentapplication Ser. No. 61/943,375, filed Feb. 22, 2014, and U.S.provisional patent application Ser. No. 61/943,397, filed Feb. 23, 2014.Each of these provisional patent applications is hereby incorporatedherein by reference. The present application further hereby incorporatesherein by reference the entire disclosure of Exhibit 1 attached hereto.

COPYRIGHT STATEMENT

All of the material in this patent document is subject to copyrightprotection under the copyright laws of the United States and othercountries. The copyright owner has no objection to the facsimilereproduction by anyone of the patent document or the patent disclosure,as it appears in official governmental records but, otherwise, all othercopyright rights whatsoever are reserved.

BACKGROUND OF THE INVENTION

The present invention generally relates to managing the care of largepopulations of patients.

Conventionally, it is common to hire large numbers of nurses or carecoordinators to manage patients and their care plans (which include, forexample, actions required of a patient). This presents several obstaclesto managing populations of patients. For example, it can be difficult toascertain how many patients each nurse/coordinator can manageeffectively. Further, it can be difficult to figure out how to handlecommunication with patients in an efficient way, and it can be difficultto determine how often nurses/coordinators should reach out to patients.

Needs exist for improvement in managing the care of large populations ofpatients. These needs, and other needs, are addressed by one or moreaspects of the present invention.

SUMMARY OF THE INVENTION

The present invention includes many aspects and features. Moreover,while many aspects and features relate to, and are described in, thecontext of population health methodologies, the present invention is notlimited to use only in this context, as will become apparent from thefollowing summaries and detailed descriptions of aspects, features, andone or more embodiments of the present invention.

Accordingly, one aspect of the present invention relates to a methodwhich includes receiving from a health care practitioner inputcorresponding to creation of a first health care order which includesone or more parameters associated with a health care goal for thepatient, one or more parameters associated with one or more rules forcommunicating notifications regarding the first health care order to thefirst health care practitioner via the electronic health recordsapplication, and instructions for the patient for complying with thefirst health care order. The method further includes displaying to thepatient a patient portal comprising a goals interface which displaysinformation associated with the first health care order for the patientcreated by the first health care practitioner, and allowing the patientto input readings for the order. The method further includescommunicating one or more notifications back to the electronic healthrecords application based on the readings.

Another aspect relates to a method which includes displaying, to a firsthealth care practitioner via a display device associated with a firstelectronic device, an interface of an electronic health recordsapplication; receiving, from the first health care practitioner via oneor more input devices associated with the first electronic device, inputcorresponding to engagement with an order creation interface element ofthe displayed interface of the electronic health records application;displaying, to the first health care practitioner via a display deviceassociated with the first electronic device, an order creation interfacefor creating a health care order configured to allow the first healthcare practitioner to specify one or more parameters associated with ahealth care goal for the patient, one or more parameters associated withone or more rules for communicating notifications regarding the healthcare order to the first health care practitioner via the electronichealth records application, and instructions for the patient forcomplying with the health care order; receiving, from the first healthcare practitioner via one or more input devices associated with thefirst electronic device, input corresponding to creation of a firsthealth care order which includes first one or more parameters associatedwith a first health care goal for the patient, second one or moreparameters associated with one or more rules for communicatingnotifications regarding the first health care order to the first healthcare practitioner via the electronic health records application, the oneor more rules including rules governing communication of a notificationthat the first health care order has not been accepted a first number ofdays after its creation, the first number of days being specified by aparameter of the second one or more parameters, communication of anotification that no reading has been input by the patient for a secondnumber of days, the second number of days being specified by a parameterof the second one or more parameters; and first instructions for thepatient for complying with the first health care order; displaying, tothe patient via a display device associated with a second electronicdevice, an interface of a patient portal comprising a goals interfacewhich displays information associated with the first health care orderfor the patient created by the first health care practitioner;receiving, from the patient via the patient portal, an indication ofacceptance of the first health care order; displaying, to the patientvia the patient portal, the first health care goal for the patient andthe first instructions for the patient for complying with the firsthealth care order; receiving data for one or more vital readingsassociated with the first health care order; automatically determining,based on the one or more vital readings, that one of the one or morerules for communicating notifications regarding the first health careorder was violated; and automatically communicating, based on thedetermination that one of the one or more rules was violated, anotification to the first health care practitioner.

In a feature of this aspect, the first electronic device comprises acomputer.

In a feature of this aspect, the first electronic device comprises atablet.

In a feature of this aspect, the first electronic device comprises aphone.

In a feature of this aspect, the first electronic device comprises atouchscreen.

In a feature of this aspect, the first health care practitionercomprises a doctor.

In a feature of this aspect, the first health care practitionercomprises a nurse.

In a feature of this aspect, the first health care practitionercomprises a physician's assistant.

In a feature of this aspect, the first health care practitionercomprises an employee of a health care entity.

In a feature of this aspect, the health care goal for the patientcomprises losing weight.

In a feature of this aspect, the health care goal for the patientcomprises gaining weight.

In a feature of this aspect, receiving data for one or more vitalreadings associated with the first health care order comprises receivingdata input by the patient via the patient portal.

In a feature of this aspect, receiving data for one or more vitalreadings associated with the first health care order comprises receivingdata from an electronic measurement device. In accordance with one ormore preferred implementations, the electronic measurement devicecomprises a scale. In accordance with one or more preferredimplementations, the electronic measurement device comprises a Withingsscale. In accordance with one or more preferred implementations, theelectronic measurement device comprises a blood pressure monitor. Inaccordance with one or more preferred implementations, the electronicmeasurement device comprises a Withings blood pressure monitor. Inaccordance with one or more preferred implementations, the electronicmeasurement device comprises a blood glucose meter. In accordance withone or more preferred implementations, the electronic measurement devicecomprises a Telcare blood glucose meter.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a patient's weightincreased by an amount specified by a parameter of the second set ofparameters over a time period specified by a parameter of the second setof parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a patient's weightdecreased by an amount specified by a parameter of the second set ofparameters over a time period specified by a parameter of the second setof parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a patient's weightincreased or decreased by an amount specified by a parameter of thesecond set of parameters over a time period specified by a parameter ofthe second set of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a patient's systolicblood pressure is greater than or equal to a value specified by aparameter of the second set of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a patient's systolicblood pressure is greater than a value specified by a parameter of thesecond set of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a patient's systolicblood pressure is less than or equal to a value specified by a parameterof the second set of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a patient's systolicblood pressure is less than a value specified by a parameter of thesecond set of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a patient's diastolicblood pressure is greater than or equal to a value specified by aparameter of the second set of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a patient's diastolicblood pressure is greater than a value specified by a parameter of thesecond set of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a patient's diastolicblood pressure is less than or equal to a value specified by a parameterof the second set of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a patient's diastolicblood pressure is less than a value specified by a parameter of thesecond set of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a vital reading isoutside of a target range by a value specified by a parameter of thesecond set of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a delta between twovital readings is greater than a value specified by a parameter of thesecond set of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a delta between twovital readings is greater than or equal to a value specified by aparameter of the second set of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a vital reading isgreater than a value specified by a parameter of the second set ofparameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a vital reading isgreater than or equal to a value specified by a parameter of the secondset of parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a vital reading isless than a value specified by a parameter of the second set ofparameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a vital reading isless than or equal to a value specified by a parameter of the second setof parameters.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a blood glucose vitalreading is outside of a target range.

In a feature of this aspect, automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated comprises automatically determining that a vital reading isoutside of a target range for a measurement time associated with thatvital reading by a value specified by a parameter of the second set ofparameters which is associated with that measurement time. In accordancewith one or more preferred implementations, the measurement time isbefore meals. In accordance with one or more preferred implementations,the measurement time is 1 to 2 hours after meals. In accordance with oneor more preferred implementations, the measurement time is beforeactivity. In accordance with one or more preferred implementations, themeasurement time is after activity. In accordance with one or morepreferred implementations, the measurement time is bedtime. Inaccordance with one or more preferred implementations, the measurementtime is overnight. In accordance with one or more preferredimplementations, the measurement time is before breakfast/fasting.

Another aspect relates to a method which includes displaying, to a firsthealth care practitioner via a display device associated with a firstelectronic device, an order creation interface for creating a healthcare order configured to allow the first health care practitioner tospecify one or more parameters associated with one or more rules forcommunicating notifications regarding the health care order to the firsthealth care practitioner via the electronic health records application,and instructions for the patient for complying with the health careorder; receiving, from the first health care practitioner via one ormore input devices associated with the first electronic device, inputcorresponding to creation of a first health care order which includes afirst set of one or more parameters associated with one or more rulesfor communicating notifications regarding the first health care order tothe first health care practitioner via the electronic health recordsapplication, the one or more rules including rules governingcommunication of a notification that the first health care order has notbeen accepted a first number of days after its creation, the firstnumber of days being specified by a parameter of the second one or moreparameters, communication of a notification that no reading has beeninput by the patient for a second number of days, the second number ofdays being specified by a parameter of the second one or moreparameters; and first instructions for the patient for complying withthe first health care order; displaying, to the patient via a displaydevice associated with a second electronic device, an interface of apatient portal comprising a goals interface which displays informationassociated with the first health care order for the patient created bythe first health care practitioner; displaying, to the patient via thepatient portal, the first instructions for the patient for complyingwith the first health care order; receiving data for one or more vitalreadings associated with the first health care order; automaticallydetermining, based on the one or more vital readings, that one of theone or more rules for communicating notifications regarding the firsthealth care order was violated; and automatically communicating, basedon the determination that one of the one or more rules was violated, anotification to the first health care practitioner.

Another aspect relates to a method which includes displaying, to a firsthealth care practitioner via a display device associated with a firstelectronic device, an order creation interface for creating a healthcare order configured to allow the first health care practitioner tospecify one or more parameters associated with one or more rules forcommunicating notifications regarding the health care order to the firsthealth care practitioner via the electronic health records application,and instructions for the patient for complying with the health careorder; receiving, from the first health care practitioner via one ormore input devices associated with the first electronic device, inputcorresponding to creation of a first health care order which includes afirst set of one or more parameters associated with one or more rulesfor communicating notifications regarding the first health care order tothe first health care practitioner via the electronic health recordsapplication, the one or more rules including rules governingcommunication of a notification that the first health care order has notbeen accepted a first number of days after its creation, the firstnumber of days being specified by a parameter of the second one or moreparameters, communication of a notification that no reading has beeninput by the patient for a second number of days, the second number ofdays being specified by a parameter of the second one or moreparameters; and first instructions for the patient for complying withthe first health care order; receiving, from the patient via the patientportal, an indication of acceptance of the first health care order;automatically determining, after a first period of time has passedwithout any reading data having been input for the first health careorder, that one of the rules of the first health care order has beenviolated because the first period of time exceeds a value specified byone of the parameters of the first set of one or more parameters;automatically communicating, based on the determination that one of therules of the first health care order was violated, a notification to thefirst health care practitioner.

In a feature of this aspect, the method further comprises determiningthat a notification has not been sent out in connection with the firstperiod of time having passed without any reading data having been input.

In a feature of this aspect, the method further comprises determiningthat a notification sent out in connection with the first period of timehaving passed without any reading data having been input was last sentout a certain number of days ago which exceeds the value specified byone of the parameters of the first set of one or more parameters.

Another aspect relates to a method which includes displaying, to a firsthealth care practitioner via a display device associated with a firstelectronic device, an order creation interface for creating a healthcare order configured to allow the first health care practitioner tospecify one or more parameters associated with one or more rules forcommunicating notifications regarding the health care order to the firsthealth care practitioner via the electronic health records application,and instructions for the patient for complying with the health careorder; receiving, from the first health care practitioner via one ormore input devices associated with the first electronic device, inputcorresponding to creation of a first health care order which includes afirst set of one or more parameters associated with one or more rulesfor communicating notifications regarding the first health care order tothe first health care practitioner via the electronic health recordsapplication, the one or more rules including rules governingcommunication of a notification that the first health care order has notbeen accepted a first number of days after its creation, the firstnumber of days being specified by a parameter of the second one or moreparameters, communication of a notification that no reading has beeninput by the patient for a second number of days, the second number ofdays being specified by a parameter of the second one or moreparameters; and first instructions for the patient for complying withthe first health care order; automatically determining, after a firstperiod of time has passed without any acceptance of the first healthcare order having been received, that one of the rules of the firsthealth care order has been violated because the first period of timeexceeds a value specified by one of the parameters of the first set ofone or more parameters; automatically communicating, based on thedetermination that one of the rules of the first health care order wasviolated, a notification to the first health care practitioner.

In a feature of this aspect, the method further comprises determiningthat a notification has not been sent out in connection with the firstperiod of time having passed without any acceptance having beenreceived.

In a feature of this aspect, the method further comprises determiningthat a notification sent out in connection with the first period of timehaving passed without any acceptance having been received was last sentout a certain number of days ago which exceeds the value specified byone of the parameters of the first set of one or more parameters.

Another aspect relates to a method which includes receiving, from afirst health care practitioner via one or more input devices associatedwith a first electronic device, input corresponding to creation of afirst health care order which includes a first set of one or moreparameters associated with one or more rules for communicatingnotifications regarding the first health care order to the first healthcare practitioner via the electronic health records application, the oneor more rules including rules governing communication of a notificationthat the first health care order has not been accepted a first number ofdays after its creation, the first number of days being specified by aparameter of the second one or more parameters, communication of anotification that no reading has been input by the patient for a secondnumber of days, the second number of days being specified by a parameterof the second one or more parameters; displaying, to the patient via adisplay device associated with a second electronic device, an interfaceof a patient portal comprising a goals interface which displaysinformation associated with the first health care order for the patientcreated by the first health care practitioner; receiving data for one ormore vital readings associated with the first health care order;automatically determining, based on the one or more vital readings, thatone of the one or more rules for communicating notifications regardingthe first health care order was violated; and automaticallycommunicating, based on the determination that one of the one or morerules was violated, a notification to the first health carepractitioner.

Another aspect relates to a method which includes receiving, from afirst health care practitioner via one or more input devices associatedwith a first electronic device, input corresponding to creation of afirst health care order which includes a first set of one or moreparameters associated with one or more rules for communicatingnotifications regarding the first health care order to the first healthcare practitioner via the electronic health records application, the oneor more rules including rules governing communication of a notificationthat the first health care order has not been accepted a first number ofdays after its creation, the first number of days being specified by aparameter of the second one or more parameters, communication of anotification that no reading has been input by the patient for a secondnumber of days, the second number of days being specified by a parameterof the second one or more parameters; displaying, to the patient via adisplay device associated with a second electronic device, an interfaceof a patient portal comprising a goals interface which displaysinformation associated with the first health care order for the patientcreated by the first health care practitioner; automatically determiningthat one of the one or more rules for communicating notificationsregarding the first health care order was violated; and automaticallycommunicating, based on the determination that one of the one or morerules was violated, a notification to the first health carepractitioner.

Another aspect relates to a method which includes displaying, to a firsthealth care practitioner via a display device associated with a firstelectronic device, an interface of an electronic health recordsapplication; receiving, from the first health care practitioner via oneor more input devices associated with the first electronic device, inputcorresponding to engagement with an order creation interface element ofthe displayed interface of the electronic health records application;displaying, to the first health care practitioner via a display deviceassociated with the first electronic device, an order creation interfacefor creating a health care order configured to allow the first healthcare practitioner to specify one or more parameters associated with ahealth care goal for the patient, one or more parameters associated withone or more rules for communicating notifications regarding the healthcare order to the first health care practitioner via the electronichealth records application, and instructions for the patient forcomplying with the health care order; receiving, from the first healthcare practitioner via one or more input devices associated with thefirst electronic device, input corresponding to creation of a firsthealth care order which includes first one or more parameters associatedwith a health care goal for the patient, second one or more parametersassociated with one or more rules for communicating notificationsregarding the first health care order to the first health carepractitioner via the electronic health records application, and firstinstructions for the patient for complying with the first health careorder; displaying, to the patient via a display device associated with asecond electronic device, an interface of a patient portal comprising agoals interface which displays information associated with the firsthealth care order for the patient created by the first health carepractitioner; receiving, from the patient via the patient portal, anindication of acceptance of the first health care order; receiving, viathe patient portal, data for one or more vital readings associated withthe first health care order; automatically determining, based on the oneor more vital readings, that one of the one or more rules forcommunicating notifications regarding the first health care order wasviolated; and automatically communicating, based on the determinationthat one of the one or more rules was violated, a notification to theelectronic health records application; displaying, to the first healthcare practitioner via a display device associated with the firstelectronic device, the notification in an interface of the electronichealth records application.

In a feature of this aspect, the first electronic device comprises acomputer.

In a feature of this aspect, the first electronic device comprises atablet.

In a feature of this aspect, the first electronic device comprises aphone.

In a feature of this aspect, the first electronic device comprises atouchscreen.

Another aspect relates to a method which includes displaying, to a firsthealth care practitioner via a display device associated with a firstelectronic device, an interface of an electronic health recordsapplication; receiving, from the first health care practitioner via oneor more input devices associated with the first electronic device, inputcorresponding to engagement with an order creation interface element ofthe displayed interface of the electronic health records application;displaying, to the first health care practitioner via a display deviceassociated with the first electronic device, an order creation interfacefor creating a health care order configured to allow the first healthcare practitioner to specify one or more parameters associated with ahealth care goal for the patient, one or more parameters associated withone or more rules for communicating notifications regarding the healthcare order to the first health care practitioner via the electronichealth records application, and instructions for the patient forcomplying with the health care order; receiving, from the first healthcare practitioner via one or more input devices associated with thefirst electronic device, input corresponding to creation of a firsthealth care order which includes first one or more parameters associatedwith a health care goal for the patient, second one or more parametersassociated with one or more rules for communicating notificationsregarding the first health care order to the first health carepractitioner via the electronic health records application, and firstinstructions for the patient for complying with the first health careorder; displaying, to the patient via a display device associated with asecond electronic device, an interface of a patient portal comprising agoals interface which displays information associated with the firsthealth care order for the patient created by the first health carepractitioner; receiving, from the patient via the patient portal, anindication of acceptance of the first health care order; automaticallydetermining, after a period of time has passed in which the patient hasnot entered any vital readings, that the patient is not complying withthe order; and automatically communicating, based on the determinationthat the patient is not complying with the order, a notification to theelectronic health records application; displaying, to the first healthcare practitioner via a display device associated with the firstelectronic device, the notification in an interface of the electronichealth records application.

Another aspect relates to a method which includes displaying, to a firsthealth care practitioner via a display device associated with a firstelectronic device, an interface of an electronic health recordsapplication; receiving, from the first health care practitioner via oneor more input devices associated with the first electronic device, inputcorresponding to engagement with an order creation interface element ofthe displayed interface of the electronic health records application;displaying, to the first health care practitioner via a display deviceassociated with the first electronic device, an order creation interfacefor creating a health care order configured to allow the first healthcare practitioner to specify one or more parameters associated with ahealth care goal for the patient, one or more parameters associated withone or more rules for communicating notifications regarding the healthcare order to the first health care practitioner via the electronichealth records application, and instructions for the patient forcomplying with the health care order; receiving, from the first healthcare practitioner via one or more input devices associated with thefirst electronic device, input corresponding to creation of a firsthealth care order which includes first one or more parameters associatedwith a health care goal for the patient, second one or more parametersassociated with one or more rules for communicating notificationsregarding the first health care order to the first health carepractitioner via the electronic health records application, and firstinstructions for the patient for complying with the first health careorder; automatically determining, after a period of time has passed inwhich the patient has not accepted the first health care order, that thepatient is not complying with the order; and automaticallycommunicating, based on the determination that the patient is notcomplying with the order, a notification to the electronic healthrecords application; displaying, to the first health care practitionervia a display device associated with the first electronic device, thenotification in an interface of the electronic health recordsapplication.

In addition to the aforementioned aspects and features of the presentinvention, it should be noted that the present invention furtherencompasses the various possible combinations and subcombinations ofsuch aspects and features. Thus, for example, any aspect may be combinedwith an aforementioned feature in accordance with the present inventionwithout requiring any other aspect or feature.

BRIEF DESCRIPTION OF THE DRAWINGS

One or more preferred embodiments of the present invention now will bedescribed in detail with reference to the accompanying drawings, whereinthe same elements are referred to with the same reference numerals, andwherein,

FIG. 1 illustrates a flow for an exemplary methodology in accordancewith one or more preferred implementations;

FIGS. 2-8C illustrate an exemplary interface for entering a weightmanagement order;

FIG. 9 illustrates another exemplary interface for entering a weightmanagement order;

FIG. 10 illustrates an exemplary flow for order analysis.

FIGS. 11A-15 illustrate exemplary interfaces for entering a weightmanagement order;

FIG. 16 illustrates an exemplary interface for entering a monitor bloodpressure order;

FIG. 17 illustrates an exemplary interface for entering a monitor bloodglucose order.

FIG. 18 illustrates an exemplary inbox of a patient portal;

FIGS. 19-20 illustrate exemplary goals interfaces for a patient portal;

FIG. 21 illustrates an exemplary consent form indicating that a useraccepted a monitor weight goal and declined a maintain blood pressuregoal;

FIG. 22 illustrates an exemplary decline goal interface;

FIG. 23 illustrates an exemplary interface for adding a vital reading inconnection with one or more goals;

FIGS. 24-25 illustrate display of readings in a goals interface;

FIG. 26 illustrates an exemplary interface for editing a vital reading;

FIG. 27 illustrates an exemplary interface for deleting a vital reading;

FIG. 28 illustrates an exemplary interface which includes a warninginterface element;

FIG. 29 illustrates an exemplary goal interface for a monitor bloodglucose order;

FIGS. 30-31 illustrate exemplary interfaces for adding a blood glucosevital reading;

FIGS. 32-33 illustrate display of blood glucose readings in a goalsinterface;

FIG. 34 illustrates an exemplary goal interface for a monitor bloodpressure order;

FIG. 35 illustrates an exemplary interface for adding a blood pressurevital reading;

FIGS. 36-37 illustrate display of blood pressure readings in a goalsinterface;

DETAILED DESCRIPTION

As a preliminary matter, it will readily be understood by one havingordinary skill in the relevant art (“Ordinary Artisan”) that the presentinvention has broad utility and application. As should be understood,any embodiment may incorporate only one or a plurality of theabove-disclosed aspects of the invention and may further incorporateonly one or a plurality of the above-disclosed features. Furthermore,any embodiment discussed and identified as being “preferred” isconsidered to be part of a best mode contemplated for carrying out thepresent invention. Other embodiments also may be discussed foradditional illustrative purposes in providing a full and enablingdisclosure of the present invention. As should be understood, anyembodiment may incorporate only one or a plurality of theabove-disclosed aspects of the invention and may further incorporateonly one or a plurality of the above-disclosed features. Moreover, manyembodiments, such as adaptations, variations, modifications, andequivalent arrangements, will be implicitly disclosed by the embodimentsdescribed herein and fall within the scope of the present invention.

Accordingly, while the present invention is described herein in detailin relation to one or more embodiments, it is to be understood that thisdisclosure is illustrative and exemplary of the present invention, andis made merely for the purposes of providing a full and enablingdisclosure of the present invention. The detailed disclosure herein ofone or more embodiments is not intended, nor is to be construed, tolimit the scope of patent protection afforded the present invention,which scope is to be defined by the claims and the equivalents thereof.It is not intended that the scope of patent protection afforded thepresent invention be defined by reading into any claim a limitationfound herein that does not explicitly appear in the claim itself.

Thus, for example, any sequence(s) and/or temporal order of steps ofvarious processes or methods that are described herein are illustrativeand not restrictive. Accordingly, it should be understood that, althoughsteps of various processes or methods may be shown and described asbeing in a sequence or temporal order, the steps of any such processesor methods are not limited to being carried out in any particularsequence or order, absent an indication otherwise. Indeed, the steps insuch processes or methods generally may be carried out in variousdifferent sequences and orders while still falling within the scope ofthe present invention. Accordingly, it is intended that the scope ofpatent protection afforded the present invention is to be defined by theappended claims rather than the description set forth herein.

Additionally, it is important to note that each term used herein refersto that which the Ordinary Artisan would understand such term to meanbased on the contextual use of such term herein. To the extent that themeaning of a term used herein—as understood by the Ordinary Artisanbased on the contextual use of such term—differs in any way from anyparticular dictionary definition of such term, it is intended that themeaning of the term as understood by the Ordinary Artisan shouldprevail.

Regarding applicability of 35 U.S.C. § 112, ¶6, no claim element isintended to be read in accordance with this statutory provision unlessthe explicit phrase “means for” or “step for” is actually used in suchclaim element, whereupon this statutory provision is intended to applyin the interpretation of such claim element.

Furthermore, it is important to note that, as used herein, “a” and “an”each generally denotes “at least one,” but does not exclude a pluralityunless the contextual use dictates otherwise. Thus, reference to “apicnic basket having an apple” describes “a picnic basket having atleast one apple” as well as “a picnic basket having apples.” Incontrast, reference to “a picnic basket having a single apple” describes“a picnic basket having only one apple.”

When used herein to join a list of items, “or” denotes “at least one ofthe items,” but does not exclude a plurality of items of the list. Thus,reference to “a picnic basket having cheese or crackers” describes “apicnic basket having cheese without crackers”, “a picnic basket havingcrackers without cheese”, and “a picnic basket having both cheese andcrackers.” Finally, when used herein to join a list of items, “and”denotes “all of the items of the list.” Thus, reference to “a picnicbasket having cheese and crackers” describes “a picnic basket havingcheese, wherein the picnic basket further has crackers,” as well asdescribes “a picnic basket having crackers, wherein the picnic basketfurther has cheese.”

Referring now to the drawings, one or more preferred embodiments of thepresent invention are next described. The following description of oneor more preferred embodiments is merely exemplary in nature and is in noway intended to limit the invention, its implementations, or uses.

When a patient is receiving medical treatment, he or she may sometimesbe presented with a care plan which will facilitate his treatment. Thecare plan may include instructions for one or more actions to perform ormeasurements to take outside of a health care professional'ssupervision. For example, a patient may be provided a care plan whichincludes instructions to weigh himself or herself every day, and recordthe results for eventual review by a health care professional.

Additionally, sometimes, a patient may be presented with a health caregoal to meet. For example, a patient may be instructed to try to meetthe goal of losing ten pounds over three months. This goal may includerelated instructions for the patient to weigh himself or herself everymorning.

One or more preferred implementations relate to a monitoring andcompliance application which improves patient engagement andcollaboration between a patient and his or her health care provider. Inone or more preferred implementations, such an application is an EHRagnostic solution that leverages existing order entry and resultsfunctionality of an EHR.

In an exemplary methodology, orders are created in an EHR for patientsto perform home monitoring. The patient is notified of the order and therequest will appear as a goal for the patient within a platform portal(such as, for example a web portal or a mobile application). The patientmay comply with the order (which might be, for example, to monitor hisor her weight daily) utilizing wireless devices (such as a Withingsscale) that can communicate data to other devices or to the platform, orby manually entering values into the platform. This home monitoring datais then evaluated against patient specific rules that were configuredwhen the order was placed. Non-compliance of the order or violation ofany of the order parameters will result in a notification that is sentback to the ordering provider as a message in the EHR. The notificationprovides summary information about the order and results allowing theprovider to determine if an intervention is necessary. Upon completionof the order, a summary of the results is sent back to the EHR forreview by the provider.

A platform in accordance with one or more preferred implementationsobviates the need for as many manual processes to monitor patients. Bymanaging patients within a platform and gaining their consent for thatmonitoring, nurses/coordinators can effectively manage their high-riskpopulations by exception. In one or more preferred implementations, itis not necessary to create follow up touch points for every patient, asnurses/coordinators will know within half an hour if a patient hasfailed a rule or is non-compliant. This allows them to focus attentionon those patients that require it.

In one or more preferred implementations, a platform provides monitoringtools to notify a provider or care team if a patient is not following anorder. Conventionally, it is common for a patient to follow an order butnot realize the medical significance of his or her vitals, results, orsymptoms. In one or more preferred implementations, a system analyzesthis data and will provide a notification (e.g. to a care team) ifsomething is potentially amiss.

In one or more preferred implementations, consumer grade devices areintegrated with a platform, or utilized in conjunction with a platform,to monitor a patient at home for variances from expected values. In oneor more preferred implementations, integration with one or more EHRsenables communication of notifications back to clinicians in their ownworkflows so as to allow them to receive such notifications withouthaving to log in to another application.

In one or more preferred implementations, monitoring data is stored atthe platform, e.g. as a personal health record. In one or more preferredimplementations, a platform is configured to allow data from multipleEHRs to be aggregated at the platform in one patient-specificrepository, together with patient input data.

In one or more preferred implementations, an application portal, such asa web portal or a mobile application, is configured for use by patientsto manage their care plans. The portal is preferably configured tocommunicate data related to such care plan back to a health careprofessional, for example by communicating data back to an electronichealth records (EHR) application utilized by the health careprofessional.

For example, in an exemplary use case, a patient is provided a healthcare plan which includes the goal of losing ten pounds over threemonths, and an instruction to measure herself every morning. The patientcan access a portal, for example via a web browser or via a mobileapplication on their phone or tablet, which allows the user to viewinformation associated with the care plan. The portal details the careplan goal and instructions, and facilitates patient compliance with thecare plan. The patient can either use a scale to find their weight eachmorning and manually input it via the portal, or alternatively canutilize a scale that is configured to automatically communicate theirweight.

Such automatic communication might, for example, involve communicationover a wired line (e.g. via USB), or might involve wirelesscommunication (e.g. via WiFi, Bluetooth, or a cellular network). Suchautomatic communication might involve communication to a nearbyelectronic device (such as a computer, laptop, tablet, or phone), orcommunication to a remote device (such as a remote server).

Weight data from the scale may be automatically communicated to anelectronic device for later communication to the portal, or to a deviceor server associated with the portal. In any event, the weight data iseventually loaded into the portal. Optionally, the portal mayautomatically review the weight data, and generate one or morenotifications or alerts if one or more values lie outside of athreshold. The portal may communicate a notification, either of thepresence of data or of an alert, to a health care provider via the EHRapplication.

FIG. 1 illustrates a flow for an exemplary methodology in accordancewith one or more preferred implementations. As illustrated in FIG. 1,first a provider places an order via an EHR. A patient receives theorder via a portal and configures wireless devices for use in complyingwith the order. For example, a user might configure a wireless scale toautomatically communicate weight data to an electronic device which inturn communicates it to the portal. The patient accepts the order in theportal, and proceeds to follow the order (for example, proceeds toweight herself every morning). Data is collected automatically as thepatient follows the order (for example, by the scale configured towirelessly communicate data).

In one or more preferred implementations, monitoring rules for an orderare established, and measurement data may be automatically evaluatedagainst the monitoring rules to determine if the patient is complyingwith the order. For example, if the order included a requirement toobtain a blood pressure measurement every morning, and the patient didnot do so on a particular day, this might be flagged as non-compliance.Such rules may be established by a health care provider at the time ofentering an order, or may be preconfigured in association with aparticular type of order. Preconfigured rules may be at least partiallyuser-configurable (e.g. a user may be able to set a value of a variable,etc.).

Further, in one or more preferred implementations, acceptable ranges maybe set and a system may be configured to determine whether measurementsare outside of such acceptable ranges such that medical intervention maybe necessary.

In the event of non-compliance with an order or a determination that ameasurement falls outside of an acceptable range, a notification is sentvia the EHR. Upon receipt of such a notification, a health careprofessional can contact the patient to follow up on the non-complianceor rules violation. Once an order is complete, results of the order areavailable via the EHR. In one or more preferred implementations, ongoingmeasurements and data are available via the EHR and the portalthroughout the course of the order, and the results are additionallyavailable via the portal and EHR upon completion of the order.

For example, consider a patient John Doe who has congestive heartfailure. His provider, Dr. Smith, has requested that John monitor hisweight every day. John is informed that if his weight increases by 3pounds in one day or by 5 pounds in 1 week, then he needs to contact hisdoctor's office. This weight gain indicates fluid retention requiringmedical intervention (e.g. John needs to have his medications adjusted).Dr. Smith places an order and provides John with a wireless Withingsscale that will automatically send his weight to the system so it can bemonitored. John is to take his weight first thing in the morning,wearing similar clothing, using the same scale, after urinating butbefore eating or drinking. John begins using the scale every morning asdirected. During the second week of monitoring, his weight increasesfrom 162.3 on Tuesday to 167.4 on Monday of the following week. Johnmiscalculates and does not realize that his weight has increased by 5pounds in 1 week. However, the system notices this change and notifieshis doctor within minutes of John stepping off the scale. John gets acall later that morning from his doctor's office informing him of theproblem and requesting that he make an appointment that day to see hisprovider. Later that afternoon Dr. Smith adjusts John's medications andhis weight returns to 162.5 pounds within a couple of days.

An exemplary system will now be described with respect to exemplaryfunctionality contemplated for congestive heart failure, diabetes,obesity, and hypertension. This system will be described with respect toorders for weight management (gaining or losing weight), weightmonitoring (providing notification of weight change), blood pressuremonitoring, and blood glucose monitoring. It will be appreciated,however, that these orders are merely exemplary, and additional ordersfor different disorders are available within the system.

In one or more preferred implementations, a weight management order isprovided which is configured to help a patient gain or lose weight overa specified time period.

In one or more preferred implementations, the order includesinstructions for a patient to only measure his or her weight once a day,preferably first thing in the morning after urinating but before eatingor drinking.

In one or more preferred implementations, several standard weight orders(e.g. “lose 10 pounds in a month” and “lose 15 pounds in two months” maybe provided and may or may not be user configurable.

In one or more preferred implementations, a weight management order isconfigurable via specification of how much weight a patient needs togain or lose, and how long they have to do it. Preferably, the initialweight, target weight, start date, and end date will all be determinedwhen a first measurement is entered by a patient.

FIG. 2 illustrates an exemplary interface for entering a weightmanagement order. The interface allows a user to specify a goal for theorder by interacting with several user interface elements. For example,a user can select whether the goal for the patient is to gain or loseweight via interaction with a drop down user interface element, asillustrated in FIG. 3. Further, a user can increase or decrease a targetweight change value via increment and decrement user interface elements,as illustrated in FIG. 4. A user can similarly specify whether a targetweight change value is expressed in pounds or kilograms. A user canfurther specify a time period for a target weight change, as illustratedin FIG. 5.

The interface further allows a user to configure rules for the weightmanagement order. The interface of FIG. 2 includes two rules that a usercan toggle on or off using radio button user interface elements, asillustrated in FIG. 6. Each of these rules includes a number of userconfigurable parameters that a user can adjust utilizing user interfaceelements, as illustrated in FIG. 7.

The interface is configured to allow a user to edit patient instructionsthat will be presented to the patient with the order. FIGS. 8A-8Cillustrate an exemplary process for editing such patient instructions.

In one or more preferred implementations, an interface for entering aweight management order is configured to allow a user to specify wherenotifications are to be sent, as illustrated in FIG. 9. Preferably, auser can indicate that notifications are to be sent to themselves andother users or user groups, as illustrated.

In one or more preferred implementations, upon creation of an order, forexample via the exemplary order interface of FIG. 2, data for the orderis stored at a platform or platform database. This data preferablyincludes data describing the order and parameters associated therewith.

For example, for an exemplary weight management order, this dataincludes a parameter which specifies how many times per unit (such as aday), the unit being specified in another parameter, that a measurementneeds to be taken.

This data preferably further includes a parameter which specifies a typeof the order, e.g. that it is a weight gain order or a weight lossorder. This data preferably further includes a parameter which specifieshow much weight is to be gained or lost. A separate parameter preferablyindicates whether this value represents pounds or kilograms.

This data preferably further includes an order duration parameter and anassociated units parameter which together specify the duration of theorder (e.g. three weeks, four days, etc.). In one or more preferredalternative implementations, a duration parameter may simply be storedin one format (e.g. days) which is understood to be the format for thisparameter.

This data preferably further includes an instructions parameter whichstores patient instructions for the order.

This data preferably further includes a status parameter whichrepresents a status of the order. In one or more preferredimplementations, a numeric status value is utilized to represent astatus. In an exemplary status representation methodology, a statusvalue of 1 indicates that a patient has accepted an order, a statusvalue of 2 indicates that a patient has declined an order, a statusvalue of 0 indicates that a patient has neither accepted nor declined anorder, a status value of 4 indicates that an order is complete, and astatus value of 3 indicates a status of non-compliance, which might, forexample, be the case if a patient has missed certain number of reasonsand a notification has been sent to a care team associated with theorder. Preferably, the next time a reading is received that counts forthe order, the status is changed to 1, indicating that the order hasbeen accepted. This allows for the prevention of repeated notificationsfor an ongoing non-compliant order, while allowing a second notificationto be sent out if a patient fails to comply, finally complies, and thenfails to comply again.

This data preferably further includes one or more patient identifiers.These identifiers may comprise, for example, an EHR patient identifier,a platform patient identifier, or a government patient identifier, suchas a social security number.

This data preferably further includes one or more provider identifiers.These identifiers may, for example, keep track of the provider thatplaced the order. This identifier may take the form of a platformprovider identifier.

This data preferably further includes an organization identifier, whichmay identify an organization where an order came from, which might, forexample, be useful for determining where to send notifications andresults.

This data preferably includes an order number, which is utilized to keeptrack of the order. In one or more preferred implementations in which anorder can be placed from an EHR, an external order identifier parameteris utilized to store an order identifier for an EHR system (e.g. an EHRsystem internal order identifier).

This data preferably further includes a start date and time parameterwhich keeps track of the date time that the order was accepted. In oneor more preferred implementations, this is stored in UTC time.

This data preferably further includes an initial weight parameter. Thisparameter is set to the first patient entered weight (e.g. manuallyinput or automatically input from a Withings scale) that is on or afterthe start date and on or before the end date. In one or more preferredimplementations, the initial weight can change, such as, for example, ifa patient accepts an order on February 21, enters a weight of 199 poundson February 22 for February 22, and then later goes back and entersweight on February 23 for both February 21 and February 23 (201 pounds,and 198 pounds, respectively). In this case, the initial weightparameter would be set on February 22 to 199 pounds, but would then bechanged to 201 pounds on February 23 when the patient input the weightmeasurement for February 21.

In one or more preferred implementations, this data further includes atarget weight parameter. This target weight represents the initialweight plus or minus the amount of weight to be gained or lost.Preferably, as the initial weight can change, this value is recalculatedbased on the initial weight and the weight to be gained or lost everytime the order is processed or evaluated.

This data preferably further includes an end date parameter. Thisparameter is preferably calculated by taking the initial date and addingthe specified duration of the order (based on the order durationparameter and the associated units parameter) to the initial date. Forexample, if the initial date was Feb. 28, 2012, and the order durationwas two years, the end date would be found by adding two years to theinitial date, resulting in an end date of Feb. 28, 2014. Preferably, acalculated end date is validated to ensure that it is a valid date, andif it is not, the next valid date is utilized. For example, if theinitial date was Feb. 29, 2012, and the order duration was two years,the end date would be Mar. 1, 2014.

This data preferably further includes a parameter representing a dateand time an order was created. This data preferably further includes aparameter representing a date and time an order was last updated.

This data preferably further includes a parameter specifying whether anotification is to be sent for missed readings. This data preferablyfurther includes a parameter specifying a number of readings that needto be missed before a notification is sent. In one or more preferredimplementations, this data further includes a parameter specifying thedate and time of the last notification for one or more missed readings.In one or more preferred implementations, this is utilized to determinewhether another notification needs to be sent. For example, if anotification was sent because a patient missed a reading seven days in arow, and then seven more days pass and the patient has missed seven morereadings, this parameter can be utilized to determine that anothernotification should be sent.

This data preferably further includes a parameter specifying whether anotification should be sent if an order hasn't been accepted. This datapreferably further includes a number of days after the order creationdate that need to have passed before a notification is sent that apatient has not accepted an order. In one or more preferredimplementations, this data further includes a parameter specifying thedate and time of the last notification for non-acceptance. In one ormore preferred implementations, this is utilized to determine whetheranother notification needs to be sent. For example, if a notificationwas sent because a patient had not accepted an order after seven days,and then seven more days pass and the patient still has not accepted theorder, this parameter can be utilized to determine that anothernotification should be sent.

Preferably, an order is periodically evaluated even if no newmeasurements or information is obtained. For example, an order ispreferably periodically evaluated to determine whether a user has failedto comply with an order and a notification of this should be sent.Preferably, the data further includes a parameter specifying the lastdate and time an order was evaluated or analyzed, which can be utilized,for example, to trigger an evaluation for non-compliance.

The data preferably further includes a parameter specifying the lastanalysis scheduled.

Preferably, data is stored for weight readings (e.g. manually inputweight measurements or automatically input weight measurements from aWithings scale) together with a date and time the reading was taken,although in one or more preferred implementations a time value isoptional. Preferably, for measurements received from a Withings scale, adate and time will be downloaded together with a weight measurement, asdata from a Withings scale may sometimes be communicated one or moredays after a measurement. Preferably, for manually input weightmeasurements, a date and time the measurement was taken will be input aswell, but in at least some implementations a date and time the readingwas input may be utilized if no date and/or time was input.

Preferably, weight readings on or after the initial date and on orbefore the end date are considered for the order, but weight readingswithout an associated date are not considered. In one or more preferredimplementations, a single weight reading for a patient may be associatedwith or stored in association with multiple orders for that patient.

An exemplary methodology for order analysis will now be described.Preferably, orders are analyzed using a patient's time zone in order toensure that the definition of a day, week, or month is consistent basedon where the patient is located and not influenced by where a provideris located.

Preferably, an order is periodically evaluated or analyzed to determinea status of the order, e.g. whether it has not been accepted, is notbeing complied with, or has been completed.

An order is determined to be in a not accepted state if the order hasbeen created and no acceptance has been received. In this state, anotification will be sent out if a specified number of days have passedsince the order creation without the order having been accepted, or ifthat specified number of days have passed since the last notification ofnon-acceptance was sent out. If a notification of non-acceptance is sentout, a parameter indicating the last time a notification ofnon-acceptance was sent out is preferably updated.

An order is determined to be in a non-compliant state if, for example,the current date (in the patient's time zone) minus the reading dateassociated with the most recent reading (in the patient's time zone) isgreater than or equal to the number of consecutive readings that need tobe missed in order to trigger non-compliance. If an order is determinedto be non-compliant, a notification is preferably sent, and the date andtime of the notification is stored. Subsequently, if the current dateminus the date of the last notification is greater than or equal to thenumber of consecutive readings that need to be missed in order totrigger non-compliance, then another notification is sent, and the dateand time of the notification is stored.

For orders in a non-compliant state, if a new reading is received whichwas added after the last evaluation date, then the status of the orderis set to accepted and the order is evaluated.

For any order with a status of accepted or not compliant, if the currentdate is after the order end date, then the order is marked completed.

In one or more preferred implementations, an order is also preferablyevaluated when data associated with a new reading is received.

FIG. 10 illustrates an exemplary flow for order analysis.

In one or more preferred implementations, a monitor weight order isprovided which is configured to facilitate monitoring of a patient'sweight over a specified time period and provide notifications based onchanges. FIG. 11A illustrates an exemplary interface for entering aweight management order.

The interface of FIG. 11A allows a user to specify how long weight is tobe taken for (a duration of the order), as well as various rules fornotifications for the order. For example, the interface of FIG. 11Aallows a user to specify that a notification should be sent if apatient's weight “increases”, “decreases”, or “increases or decreases” aspecified amount over a specified time period, as illustrated in FIG.11B.

In one or more preferred implementations, an interface is configured toallow a user to add rules to an order, as illustrated in FIG. 12. Theinterface may be configured to allow a user to add a specific type ofrule, such as, for example, a weight change notification rule, a missedreading notification rule, or a failure to consent notification rule, asillustrated in FIG. 13. In one or more preferred implementations, a useris even able to add a custom rule with fields and parameters of theirchoosing. FIG. 14 illustrates addition of a weight change notificationrule to the interface of FIG. 12.

In one or more preferred implementations, an interface may additionallybe configured to allow a user to remove rules, as illustrated in FIG.15.

It will be appreciated that notifications might be sent for multiplerules associated with a single order. In one or more preferredimplementations, data for the order includes data keeping track ofnotifications sent for each rule of the order. In one or more preferredimplementations, sending out a notification for a first rule of an orderdoes not preclude sending out a second notification for a second rule ofthe same order, while in one or more preferred implementations, it may.In one or more preferred implementations, this may be user configurable.Preferably, data for an order includes data for each notification thatis sent, including information relating to which rule triggeredcommunication of the notification.

In one or more preferred implementations, if during an order evaluationit is determined that multiple rules are triggered, information relatingto all of the rules that have been triggered is included in a singlenotification, rather than having multiple notifications be sent,although in at least some implementations, multiple notifications may besent.

An exemplary methodology for evaluating a rule includes first findingall readings that were taken after the order start date up until theorder end date, which can be characterized as an order reading set. Thereadings are then cycled through in reverse chronological order, withthe newest readings evaluated first. For each respective reading, a dateand time for the reading is determined, and the rule period issubtracted from this date and time. For example, if the rule involvesmonitoring to determine if weight increases by three pounds in threedays, then the rule period would be three days. Subtracting the ruleperiod from the date and time associated with the respective readingsets a date starting point for consideration of that rule for thatrespective reading, although this date starting point cannot be beforethe order starting date. Next, all readings that occurred on or afterthe date starting point but before the date and time associated with therespective reading are loaded as a reading set, and each reading in thereading set is evaluated against the respective reading. If the rule isconfigured to determine if weight increases a set rule amount, then theprocess involves evaluating whether the respective reading value minusany value in the reading set is greater than or equal to the set ruleamount (or whether any value in the reading set plus the set rule amountis greater than or equal to the respective reading value). If the ruleis configured to determine if weight decreases a set rule amount, thenthe process involves evaluating whether any value in the reading setminus the respective reading value is greater than or equal to the setrule amount (or whether any value in the reading set minus the set ruleamount is less than or equal to the respective reading value). In one ormore preferred implementations, if the rule is configured to determineif weight increases or decreases a set rule amount, this is evaluated asif evaluating both an increases rule and a decreases rule, while in oneor more alternative preferred implementations, the process involvesevaluating whether the absolute value of any value in the reading setminus the respective reading value (or vice versa) is greater than orequal to the set rule amount.

This process is repeated for each reading in the order reading set,although it may be cut short if a determination is made that the rulehas been violated. This process is then repeated for other rules of theorder.

In one or more preferred implementations, a monitor blood pressure orderis provided which is configured to facilitate monitoring of a patient'sblood pressure over a specified time period and provide notificationsbased on changes. FIG. 16 illustrates an exemplary interface forentering a monitor blood pressure order. As illustrated, the interfaceallows a user to specify a goal for a patient, e.g. to have a bloodpressure higher than specified values, or lower than specified values.

In one or more preferred implementations, a monitor blood glucose orderis provided which is configured to facilitate monitoring of a patient'sblood glucose over a specified time period and provide notificationsbased on changes. FIG. 17 illustrates an exemplary interface forentering a monitor blood glucose order.

As illustrated, the interface allows a user to specify times when apatient should take a blood glucose reading. The interface furtherallows a user to specify target ranges for each of these times. Forexample, an order may instruct a user to take a blood glucose readingone to two hours after meals, and indicate that the target range for ablood glucose reading taken at such a time is 60 to 179 mg/dL. In one ormore preferred implementations, an interface allows a user to addadditional target ranges (e.g. for other measurement times).

The interface further allows a user to specify rules for the order whichmay trigger notifications. For example, the interface allows a user tospecify that if a patient fails to make a specified percentage ofreadings over a specified time period, then a notification should besent out.

The interface further allows a user to specify conditions for when anotification should be sent out in response to a reading outside of adefined range. For example, the interface allows a user to specify thata notification should be sent out if a reading is a specified amountoutside of a target range, or if any reading is outside of a specifiedrange.

In one or more preferred implementations, a system preferably includes apatient portal that allows a patient to log in and view orders that havebeen created for them. Preferably, when a new order is created for apatient, an electronic message informing them of the new order isgenerated and communicated to the patient, for example to an inbox ofthe patient portal or to an email address associated with the patient.FIG. 18 illustrates an exemplary inbox of a patient portal whichincludes such a communication.

In one or more preferred implementations, a patient portal preferablyincludes a goals interface which relates to orders placed by a provider(e.g. via an EHR). These orders are presented to patients via thepatient portal as goals. For example, they might have a goal to keeptheir blood pressure below a certain level, or lose a certain amount ofweight.

FIG. 19 illustrates an exemplary goals interface for a patient portal.The goals interface preferably includes elements configured to allow auser to view completed and declined goals, as illustrated. The goalsinterface preferably further includes elements configured to allow auser to view active goals, should they have any active goals.

The goals interface informs a user if they have any new goals, andprompts them to get started on those goals if they do. Upon clicking onsuch prompt, a user is presented with a new goals interface which allowsthe user to accept or decline new goals, as illustrated in FIG. 20. Thenew goals interface presents the new goals that have not yet beenaccepted or declined, and allows a user to accept or decline each goal.

Preferably, once a user has accepted or declined each goal, a consentform is automatically generated for each provider which indicates theacceptance or declining of each goal for that provider. If the new goalsinterface included goals for multiple providers, then a separate consentform will be generated for each provider. FIG. 21 illustrates anexemplary consent form indicating that a user accepted a monitor weightgoal and declined a maintain blood pressure goal.

Returning to FIG. 19, the goals interface illustrates an active goal forthe user of losing fifteen pounds in four months. Notably, a user candecline this goal via this interface, even though it is already active.Clicking on a link to decline this goal will bring up a decline goalinterface, as illustrated in FIG. 22. Declining this goal will generateanother consent form indicating that this goal was declined.

Returning once more to FIG. 19, this goal has been accepted but has notyet been started because a reading has not yet been entered. To proceed,a user would need to either enter his or her weight, or connect aWithings scale.

FIG. 23 illustrates an exemplary interface for adding a vital reading inconnection with one or more goals. The add vital interface allows theuser to specify what type of vital he is providing input for (e.g.weight, blood pressure, etc.), and further allows a user to specify areading value, a date the reading was taken, and comments for thereading. Once the first reading is input that counts for a goal, thatgoal has been started, and the readings for that goal are displayed onthe goal interface, as illustrated in FIG. 24. Over time, hopefully, aplurality of readings will be entered into the system, either manuallyor via a Withings scale, as illustrated in FIG. 25.

This interface preferably includes user interface elements configured toallow a user to edit a reading. Interacting one of these user interfaceelements brings up an edit vital interface, as illustrated in FIG. 26.In one or more preferred implementations, however, a user is only ableto edit previously entered vital measurements if they were notautomatically loaded from another source, such as a Withings scale. Inone or more preferred implementations, data automatically loaded from aWithings scale or other similar system must be edited through a systemor portal associated with the device, in order to avoid sync issues.

The interface preferably further includes user interface elementsconfigured to allow a user to delete readings. Preferably, however, thiswill only delete the readings in the user's portal, and will not deletereadings from a provider's EHR. FIG. 27 illustrates an exemplaryinterface for confirming a delete operation.

While FIG. 25 illustrates an exemplary interface for a weight lossorder, FIG. 28 illustrates an exemplary interface for a monitor weightorder. Preferably, the same weight readings are potentially applicableto both orders, and separate weight readings will not necessarily needto be input for each order, even though the orders may have separatestart and end dates. As illustrated in FIG. 28, for the monitor weightorder, a statement related to the rules set for the monitoring isincluded on the interface for the user to see. Further, any readingwhich triggers a rule violation is preferably indicated via a warninginterface element, as illustrated in FIG. 28. A user can preferablyhover over such a warning interface element to view details related tothe warning, as illustrated.

FIG. 29 illustrates another goal interface for a monitor blood glucoseorder. The goal interface for the monitor blood glucose order includesone or more graphical elements indicating ranges that the patient shouldaim to keep his or her blood glucose levels within. A user can inputblood glucose readings manually or by using a blood glucose meter whichcan be specially configured similarly to a Withings scale, such as aTelcare blood glucose meter. When inputting a blood glucose reading, auser can tag the blood glucose reading to indicate when the reading wastaken, as illustrated in FIG. 30. In one or more preferredimplementations, a drop down user interface element is configured toallow a user to tag when the reading was taken, as illustrated in FIG.31. Preferably, the drop down user interface element includes an optionto leave the field blank.

Once the first reading is input that counts for a goal, that goal hasbeen started, and the readings for that goal are displayed on the goalinterface, as illustrated in FIG. 32. Over time, hopefully, a pluralityof readings will be entered into the system, either manually or via aspecially configured blood glucose monitor, as illustrated in FIG. 33.

FIG. 34 illustrates another goal interface for a maintain blood pressureorder. For this order, a user can input blood pressure readings manuallyor by using a specially configured blood pressure device such a Withingsblood pressure monitor. FIG. 35 illustrates an exemplary interface foradding a blood pressure vital reading.

Once the first reading is input that counts for a goal, that goal hasbeen started, and the readings for that goal are displayed on the goalinterface, as illustrated in FIG. 36. Over time, hopefully, a pluralityof readings will be entered into the system, either manually or via aspecially configured blood pressure monitor, as illustrated in FIG. 37.Additionally, in one or more preferred implementations, readings may beentered by a health care provider, as illustrated in FIG. 37, in which areading taken on Oct. 15, 2013 was entered by a Jardogs Clinic healthcare provider.

In one or more preferred implementations, a platform is configured tocommunicate notifications when an order is not being followed or a rulefor an order has been violated. Preferably, the platform analyzes anorder when data (e.g. in the form of a reading) comes in for that order,as well as periodically (e.g. to check for non-compliance with theorder). Preferably, if it is determined that a notification is to besent for a particular patient for a particular order, then anotification message is queued up in a queue. The platform thenpreferably waits a predetermined period, such as fifteen minutes, todetermine if any additional notification messages need to be sent forthat patient. After expiration of the period, the platform willpreferably bundle together any notifications for the same patient forthe same order for the same provider and send the bundled notificationto the provider (and/or another entity that it is indicated anotification should be sent to).

In one or more preferred implementations, there are four basic types ofnotifications. A first is a declined notification, which notifies aprovider that an order has been declined. A second is a not acceptednotification, which notifies a provider that an order has not beenaccepted after a specified number of days. A third is a non-compliantnotification, which notifies a provider that a patient has accepted anotification but is not complying with the order and has missed thenumber of readings specified to trigger a notification. A fourth is abroken rule notification, which indicates that a rule associated withthe order has been violated. This type of notification indicates to theprovider that something may be wrong, and may require follow up.

These notifications may take the form of a notification to a providerwithin an EHR application, or an electronic communication to a provider,such as an email or text message.

Based on the foregoing description, it will be readily understood bythose persons skilled in the art that the present invention issusceptible of broad utility and application. Many embodiments andadaptations of the present invention other than those specificallydescribed herein, as well as many variations, modifications, andequivalent arrangements, will be apparent from or reasonably suggestedby the present invention and the foregoing descriptions thereof, withoutdeparting from the substance or scope of the present invention.Accordingly, while the present invention has been described herein indetail in relation to one or more preferred embodiments, it is to beunderstood that this disclosure is only illustrative and exemplary ofthe present invention and is made merely for the purpose of providing afull and enabling disclosure of the invention. The foregoing disclosureis not intended to be construed to limit the present invention orotherwise exclude any such other embodiments, adaptations, variations,modifications or equivalent arrangements, the present invention beinglimited only by the claims appended hereto and the equivalents thereof.

What is claimed is:
 1. A method comprising: (a) displaying, to a firsthealth care practitioner via a display device associated with a firstelectronic device, an interface of a first electronic health recordsapplication; (b) receiving, from the first health care practitioner viaone or more input devices associated with the first electronic device,input corresponding to engagement with an order creation interfaceelement of the displayed interface of the first electronic healthrecords application; (c) displaying, to the first health carepractitioner via a display device associated with the first electronicdevice, an order creation interface for creating a health care orderconfigured to allow the first health care practitioner to specify (i)one or more parameters associated with a health care goal for thepatient, (ii) one or more parameters associated with rules forcommunicating notifications regarding the health care order to the firsthealth care practitioner via the electronic health records application,and (iii) instructions for the patient for complying with the healthcare order; (d) receiving, from the first health care practitioner viaone or more input devices associated with the first electronic device,input corresponding to creation of a first health care order whichincludes (i) first one or more parameters associated with a first healthcare goal for the patient, (ii) second one or more parameters associatedwith one or more rules for communicating notifications regarding thefirst health care order to the first health care practitioner via thefirst electronic health records application, the one or more rulesincluding rules governing (A) communication of a notification that thefirst health care order has not been accepted a first number of daysafter its creation, the first number of days being specified by aparameter of the second one or more parameters, (B) communication of anotification that no reading has been input by the patient for a secondnumber of days, the second number of days being specified by a parameterof the second one or more parameters, and (C) communication of anotification if a reading is outside of a target range specified by oneor more parameters of the second one or more parameters; and (iii) firstinstructions for the patient for complying with the first health careorder; (e) displaying, to a second health care practitioner via adisplay device associated with a second electronic device, an interfaceof a second electronic health records application; (f) receiving, fromthe second health care practitioner via one or more input devicesassociated with the second electronic device, input corresponding toengagement with an order creation interface element of the displayedinterface of the second electronic health records application; (g)displaying, to the second health care practitioner via a display deviceassociated with the second electronic device, an order creationinterface for creating a health care order configured to allow the firsthealth care practitioner to specify (i) one or more parametersassociated with a health care goal for the patient, (ii) one or moreparameters associated with rules for communicating notificationsregarding the health care order to the first health care practitionervia the electronic health records application, and (iii) instructionsfor the patient for complying with the health care order; (h) receiving,from the second health care practitioner via one or more input devicesassociated with the second electronic device, input corresponding tocreation of a second health care order which includes (i) third one ormore parameters associated with a first health care goal for thepatient, (ii) fourth one or more parameters associated with one or morerules for communicating notifications regarding the first health careorder to the first health care practitioner via the second electronichealth records application, the one or more rules including rulesgoverning (A) communication of a notification that the first health careorder has not been accepted a first number of days after its creation,the first number of days being specified by a parameter of the secondone or more parameters, (B) communication of a notification that noreading has been input by the patient for a second number of days, thesecond number of days being specified by a parameter of the second oneor more parameters, and (C) communication of a notification if a readingis outside of a target range specified by one or more parameters of thesecond one or more parameters; and (iii) second instructions for thepatient for complying with the second health care order; (i) displaying,to the patient via a display device associated with a third electronicdevice, an interface of a patient portal comprising a goals interfacewhich displays information associated with the first health care orderfor the patient created by the first health care practitioner; (j)receiving, from the patient via the patient portal, an indication ofacceptance of the first health care order; (k) displaying, to thepatient via the patient portal, the first health care goal for thepatient and the first instructions for the patient for complying withthe first health care order; (l) receiving data for one or more vitalreadings associated with the first health care order; (m) automaticallydetermining, as a first determination, that one of the readings isoutside of a target range specified by one or more parameters of thesecond one or more parameters; (n) automatically communicating, based onthe first determination, a notification to the first health carepractitioner; (o) displaying, to the patient via a display deviceassociated with the third electronic device, an interface of the patientportal comprising a goals interface which displays informationassociated with the second health care order for the patient created bythe second health care practitioner; (p) receiving, from the patient viathe patient portal, an indication of acceptance of the second healthcare order; (q) receiving data for one or more vital readings associatedwith the second health care order; (r) automatically determining, as asecond determination, that one of the readings is outside of a targetrange specified by one or more parameters of the fourth one or moreparameters; and (s) automatically communicating, based on the seconddetermination, a notification to the second health care practitioner. 2.The method of claim 1, wherein the first electronic device comprises atouchscreen.
 3. The method of claim 1, wherein the health care goal forthe patient comprises losing or gaining weight.
 4. The method of claim1, wherein receiving data for one or more vital readings associated withthe first health care order comprises receiving data input by thepatient via the patient portal.
 5. The method of claim 1, whereinreceiving data for one or more vital readings associated with the firsthealth care order comprises receiving data from an electronicmeasurement device.
 6. The method of claim 5, wherein the electronicmeasurement device comprises a scale.
 7. The method of claim 5, whereinthe electronic measurement device comprises a blood pressure monitor. 8.The method of claim 5, wherein the electronic measurement devicecomprises a blood glucose meter.
 9. A method comprising: (a) displaying,to a first health care practitioner via a display device associated witha first electronic device, an interface of a first electronic healthrecords application; (b) receiving, from the first health carepractitioner via one or more input devices associated with the firstelectronic device, input corresponding to engagement with an ordercreation interface element of the displayed interface of the firstelectronic health records application; (c) displaying, to the firsthealth care practitioner via a display device associated with the firstelectronic device, an order creation interface for creating a healthcare order configured to allow the first health care practitioner tospecify (i) one or more parameters associated with a health care goalfor the patient, (ii) one or more parameters associated with rules forcommunicating notifications regarding the health care order to the firsthealth care practitioner via the electronic health records application,and (iii) instructions for the patient for complying with the healthcare order; (d) receiving, from the first health care practitioner viaone or more input devices associated with the first electronic device,input corresponding to creation of a first health care order whichincludes (i) first one or more parameters associated with a first healthcare goal for the patient, (ii) second one or more parameters associatedwith one or more rules for communicating notifications regarding thefirst health care order to the first health care practitioner via thefirst electronic health records application, the one or more rulesincluding rules governing (A) communication of a notification that thefirst health care order has not been accepted a first number of daysafter its creation, the first number of days being specified by aparameter of the second one or more parameters, (B) communication of anotification that no reading has been input by the patient for a secondnumber of days, the second number of days being specified by a parameterof the second one or more parameters, and (C) communication of anotification if a reading is outside of a target range specified by oneor more parameters of the second one or more parameters; and (iii) firstinstructions for the patient for complying with the first health careorder; (e) displaying, to a second health care practitioner via adisplay device associated with a second electronic device, an interfaceof a second electronic health records application; (f) receiving, fromthe second health care practitioner via one or more input devicesassociated with the second electronic device, input corresponding toengagement with an order creation interface element of the displayedinterface of the second electronic health records application; (g)displaying, to the second health care practitioner via a display deviceassociated with the second electronic device, an order creationinterface for creating a health care order configured to allow the firsthealth care practitioner to specify (i) one or more parametersassociated with a health care goal for the patient, (ii) one or moreparameters associated with rules for communicating notificationsregarding the health care order to the first health care practitionervia the electronic health records application, and (iii) instructionsfor the patient for complying with the health care order; (h) receiving,from the second health care practitioner via one or more input devicesassociated with the second electronic device, input corresponding tocreation of a second health care order which includes (i) third one ormore parameters associated with a first health care goal for thepatient, (ii) fourth one or more parameters associated with one or morerules for communicating notifications regarding the first health careorder to the first health care practitioner via the second electronichealth records application, the one or more rules including rulesgoverning (A) communication of a notification that the first health careorder has not been accepted a first number of days after its creation,the first number of days being specified by a parameter of the secondone or more parameters, (B) communication of a notification that noreading has been input by the patient for a second number of days, thesecond number of days being specified by a parameter of the second oneor more parameters, and (C) communication of a notification if a readingis outside of a target range specified by one or more parameters of thesecond one or more parameters; and (iii) second instructions for thepatient for complying with the second health care order; (i) displaying,to the patient via a display device associated with a third electronicdevice, an interface of a patient portal comprising a goals interfacewhich displays information associated with the first health care orderfor the patient created by the first health care practitioner andinformation associated with the second health care order for the patientcreated by the second health care practitioner; (j) receiving, from thepatient via the patient portal, an indication of acceptance of the firsthealth care order; (k) displaying, to the patient via the patientportal, the first health care goal for the patient and the firstinstructions for the patient for complying with the first health careorder; (l) receiving data for one or more vital readings associated withthe first health care order; (m) automatically determining that one ofthe readings is outside of a target range specified by one or moreparameters of the second one or more parameters; and (n) automaticallycommunicating, based on the determination, a notification to the firsthealth care practitioner.
 10. A method, the method being implemented fora system that includes a plurality of electronic health recordsapplications and a patient portal platform, the method including animprovement comprising configuring the patient portal platform to (a)receive orders input via any of the plurality of electronic healthrecords applications, and (b) communicate order information for arespective received order, including vital readings, back to arespective electronic health records applications from which therespective order was received, (c) such that the patient portal platformcan be characterized as being electronic health records applicationagnostic.